Plasma circulating tumor DNA as a potential tool for disease monitoring in head and neck cancer

Abstract

Background Recommendations for perioperative therapy in head and neck cancer are not explicit and recurrence occurs frequently. Circulating tumor DNA is an emerging cancer biomarker, but has not been extensively explored for detection of recurrence in head and neck cancer. Methods Patients diagnosed with head and neck squamous cell carcinoma were recruited into the study protocol. Tumors were sequenced to identify patient‐specific mutations. Mutations were then identified in plasma circulating tumor DNA from pre‐treatment blood samples and longitudinally during standard follow‐up. Circulating tumor DNA status during follow‐up was correlated to disease recurrence. Results Samples were taken from eight patients. Tumor mutations were verified in seven patients. Baseline circulating tumor DNA was positive in six patients. Recurrence occurred in four patients, two of whom had detectable circulating tumor DNA prior to recurrence. Conclusion Circulating tumor DNA is a potential tool for disease and recurrence monitoring following curative therapy in head and neck cancer, allowing for better prognostication, and/or modification of treatment strategies.

Decline in circulating viral and human tumor markers after resection of head and neck carcinoma

“…Like prior studies, 10,18 our work supports the notion that advanced disease stage or poorly differentiated tumor grade corresponds with detectable plasma mutations. While the identification of positive plasma tumor markers is a strong indicator of active tumor, a negative result does not exclude active tumor 17,25,37 . Indeed, half of the patients with HNSCC in this cohort did not have detectable plasma tumor markers.…”

“…Prior studies of HNSCC have evaluated tumor markers using polymerase chain reaction (PCR) or sequencing technologies to detect human gene variants or to quantify HPV load in plasma 17,24‐28,30,31,37‐41 . The ability of sequencing panels to track multiple tumor markers at once should generate more precise measurements of tumor clones and emerging aggressive subclones.…”

“…Unlike tumor tissue biopsy, cfDNA in blood can be sampled conveniently at sequential timepoints, which could allow for more frequent monitoring of tumor status 9‐11 . Early studies show that cfDNA tests are practical for evaluating treatment response across a number of cancer types, 12‐16 including HNSCC 10,17‐20 . In addition to somatic variants in human genes, viral genome levels in virally mediated cancers can be tracked over time, and results of such assays help assess tumor burden, clonal evolution or emerging treatment resistance 21‐31 .…”

Анализ Внеклеточной Фракции РНК Плазмы Как Инструмент Диагностики В Онкологии

“…Анализ внеклеточной фракции ДНК как диагностический инструмент в онкологии используют уже более 20 лет, применяя при раках легких [5,6], головы и шеи [7], пищевода [8], молочной железы [9], печени [10], толстой кишки [11], поджелудочной железы [12], почек [13] и др. Как правило, определяют наличие мутаций онкогенов, геновсупрессоров опухоли или микросателлитные изменения BULLETIN OF RSMU 3, 2020 VESTNIKRGMU.RU | | [6,9,13].…”

Circulating RNA in blood plasma as diagnostic tool for clinical oncology

“…The analysis of circulating DNA has been used in clinical oncology for over 20 years to aid the diagnosis and monitoring of the following cancers: lung [5,6], head and neck [7], esophageal [8], breast [9], hepatic [10], colon [11], pancreatic [12], renal [13], and others. As a rule, the tests look for the presence of mutations in oncogenes, tumor suppressor genes and microsatellites [6,9,13].…”